Patients who have been referred to and assessed by the Community Gynaecology Service who have been advised to undergo further investigation by way of a hysteroscopy can be offered the choice of an outpatient hysteroscopy within the service if appropriate instead of being referred to secondary care.
Hysteroscopy is a technique which allows a doctor to look directly into the womb with a thin telescope. It is passed gently through the cervix and attached to a camera so that a clear view of the inside of the womb is seen. Patients can also watch on the TV screen!
A small biopsy can be taken if needed and small polyps or even lost coils can be removed.
We use state-of-the-art ultra-thin Gynaecare hysteroscopes and the procedure nowadays does not require hospital admission or a general anaesthetic. Our hysteroscopes are supplied by Ethicon, a division of Johnson&Johnson Medical Ltd.
The most common reason is to help identify the cause of heavy or irregular periods. It is also needed if there has been bleeding after the menopause. If a patient has a coil in place which needs removing, this can be performed during a hysteroscopy.
Patients may feel a little discomfort rather than pain and will usually be advised to take some simple painkillers beforehand. If needed, some local anaesthetic can be used in the cervix, but the telescopes are so delicate that some patients hardly notice it.
Patients should anticipate being at the clinic for about an hour, although the procedure itself takes about 20mins. If any minor procedures need to be done, then this may take a bit longer.
In the UK, about 20,000 people a year have their womb examined in this way. Very few problems have been encountered and patients are fully informed beforehand. On rare occasions, it may cause an infection and some heavy bleeding which should settle with a course of antibiotics. Very rarely, the camera may make a tiny hole in the womb but this usually heals well and does not cause any long term problems.
Patients can rest in the clinic after the procedure and can then go home. Most patients would prefer to have someone with them to take them home. Some patients have a period-like pain for 24hrs afterwards but some simple painkillers will help. Any heavy bleeding or severe pain should be reported to the clinic or patient’s own GP.
Any findings will be discussed during the procedure itself but the results of any biopsies are usually available after 2-3weeks. The result may be conveyed by letter or some patients may require a follow up visit to the clinic.
Hertfordshire Hysteroscopy Leaflet - March 2018